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Case Reports
. 2020 Jul 25:11:205.
doi: 10.25259/SNI_569_2019. eCollection 2020.

Brainstem abscess treated conservatively

Camila Furtado Leao  1 , Maira Piani Couto  2 , Jose Antonio Santos de Lima  2 , Eric Homero Albuquerque Paschoal  3 , Jose Reginaldo Nascimento Brito  2
Affiliations
Case Reports

Brainstem abscess treated conservatively

Camila Furtado Leao et al. Surg Neurol Int. .

Abstract

Background: Brainstem abscess is a rare condition with a variety of treatment approaches. In this paper, we report an unusual case of a brainstem abscess with a positive outcome in an immunocompetent patient who was treated with antibiotic therapy.

Case description: A 22-year-old female presented with bilateral tetraparesis that was worse on the left hemibody, appendicular tremor, and left upper eyelid ptosis. Brain magnetic resonance imaging showed an abscess in the pons and midbrain due to possible nocardiosis. She was treated with dexamethasone, phenytoin, vancomycin, and meropenem for 8 weeks and trimethoprim-sulfamethoxazole for 6 weeks. The brain injury decreased, and the patient's neurological status significantly improved.

Conclusion: Brainstem abscess may be treated conservatively, leading to improvement of the clinical condition and decreased lesion size on imaging.

Keywords: Antibiotic therapy; Brain abscess; Brainstem; Nocardia infections.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
(a) Magnetic resonance imaging showing contrast (gadolinium) lesions in the pons and midbrain in the sagittal orientation before antibiotic treatment. (b) Magnetic resonance imaging showing contrast (gadolinium) lesions in the pons and midbrain in the axial orientations before antibiotic treatment.
Figure 2:
Figure 2:
(a) Magnetic resonance imaging showing contrast (gadolinium) lesions in the pons and midbrain in the sagittal orientation after antibiotic treatment. (b) Magnetic resonance imaging showing contrast (gadolinium) lesions in the pons and midbrain in the axial orientation after antibiotic treatment.
See this image and copyright information in PMC

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